Keeping regulators at bay
MOC does have a major advantage: It reduces the likelihood that state licensing boards will issue onerous requirements focused on lifelong learning and practice assessment. If each state licensing board established unique requirements for practice assessment, physicians would confront a complex patchwork of local regulations that might be more burdensome than MOC.
What do early results show?
A few specialties have been using the principles of MOC in the recertification process for several years. Physicians who have participated in MOC have reported that, as a result of their practice assessment, they 1) implement, to a greater extent, patient flow sheets for tracking complex care processes; 2) provide better tracking of vaccinations and smoking status; and 3) use patient education materials more often.
Physicians also report, however, that MOC is time-consuming and increases the cost of certification.
Then there’s HFn (the hassle factor)
At every regulatory level, physicians face greater and greater scrutiny and bureaucratic stipulations that undermine their ability to manage both their practice and their professional development efficiently. The myriad, and often overlapping, agencies and processes that hold sway over physician practice include the following:
- specialty board certification (e.g., MOC)
- state licensing boards (CME requirements)
- hospital credentialing (a complex process of data collection from diverse sources)
- federal and state drug licensing
- credentialing with each health-care insurer
- professional liability insurers (completion of specified education programs to maintain insurability)
- increased reporting requirements focused on “conflicts of interest.”
MOC will add to this regulatory burden and, it’s likely, grow more complex.
MOC is here to stay
One component of MOC, ABOG’s ABC program, is being used by many physicians. It’s widely perceived as enjoyable and a positive process for continuing education. My experience is that the physician–leaders at ABOG have done an outstanding job of selecting high-quality, clinically relevant articles for the ABC. Compared with other similar products, such as the New England Journal of Medicine’s continuing education program, the ABC is exceptionally well done. The ABC is time-consuming, but I found it an out-standing educational experience.
What about the other core elements of MOC, including the proctored, secure, and expensive cognitive exam? I think they will be widely viewed with disdain by ObGyns. Do you agree?